Know more about caesarean section before you get one done...read through the indications ,types , procedures , post operative complications and care.

      

       CAESAREAN SECTION:

•An operative procedure for the removal of foetus from the uterus by abdominal incision after 28 weeks of pregnancy is termed as "Caesarean Section".

•It is called hysterectomy if done before 28 weeks.

•According to a legend Julius Caesar was born by this operation hence the name came into play.

•WHO recommends CS  at 15-20%.

•It is one of the commonest surgeries now. 

Some common myths about

 c -section :

•Once a c sec always a c sec.

         (dr. e.b. cargin 1961)

Modified to :

•Once a sec not always a sec.

Now modified to:

•Once a sec always a hospital delivery. 

INDICATIONS :

Thoroughly go through the below points so as to cross check that you have the need of c sec or only being fooled by the surgeon to make money:

•Contracted pelvis or CPD.

•Diabetes

•Eclampsia

•Placenta previa

•Mal presentation

•Genital herpes

•Pelvic tumours

•Post mortem c sec

•“Precious babies”

•  Macrosomia

•Previous csec if:

üPrevious csec was upper seg c sec

üContracted pelvis

üVaginal bleeding during current labor

üMarked tenderness over the scar.

So only and only these conditions require caesarean sec agree only if your reports state one of the above conditions. 

TYPES:

1.)A/C to timing :

•ELECTIVE C SEC: The operation is done at a preselected time before onset of labor.

•SELECTIVE C SEC: the operation is done after the onset of labor.

2.) A/C to site of c sec:

•USCS: (Classical) : longitudinal paramedian incision in the upper segment .

                 

•LSCS : (Common) : a pfannenstiel transverse incision in the lower uterine segment are used. 

PROCEDURE :

             SKIN

                 I

   SUBCUTANEOUS FAT

                I                

  RECTUS SHEATH

                 I                               

      LINEA ALBA 

                 I

 EXPOSE THE RECTUS MUSCLE,PERITONEUM &      URINARY BLADDER

   

              I  

                           

RETRACT LATERALLY

                 I              

HEAD IS DELIVERED 

                 I

BODY IS DELIVERED

                 

                 I                   

                   

    PLACENTA IS 

     DELIVERED

                                     

                 I

                                                 SUTURING

POST OPERATIVE COMPLICATION:

 •Haemorrhage

•Wound infection

•DVT

•Pulmonary embolism

•Pelvic abscess

•Respiratory 

 complications

•Incisional hernia 

POST OPERATIVE CARE:

 •Close monitoring for 6-8 hours.

•Blood transfusion If needed.

•Analgesics & sedatives.

•Oral fluids.

•Discharged 

       

Know about neuroglia cells , their chatacteristics, functions & disorders....

                                       

                                 

NEURONS :

ü  Excitable cells

ü  Generate action potential

ü  Is the basic structural & functional unit of the nervous system

ü  Present in CNS,PNS &ANS. 

GLIAL CELLS :

                                     

ü Non excitable cells

ü Do not generate action potential

ü Supporting connective tissue

ü Present mainly in CNS

GLIOGENESIS

ü In the primitive organisms, neurons used to do glial functions but as their specialization  took place they became perfect elements for signaling & information processing .

ü There housekeeping function went to these glial cells first in “ PLATYHELMINTHES 

CHARACTERISTICS:

• They can replace themselves.

•They can divide throughout life.

•Much smaller than neurons but more numerous.

Make up half the mass of brain.

CLASSIFICATION:

CNS:

ØAstrocytes

ØOligodendrocytes

ØMicroglia

Ependymal

PNS:

ØSchwann cells

ØSatellite cells

        ASTROCYTES

§Forms the blood brain barrier.

§Senses when neuron releases glutamate.

§Forms scar like tissue following a CNS injury.

§Involved  in synapse formation in developing  neural tissue. 

 

                   SATELLITE CELLS

•Surround neuronal cell bodies within ganglia.

•Regulate neural environment.

•Found in PNS.

•Support and protect neurons.

OLIGODENDROCYTES & SCHWANN CELLS:

                                      

•They both provide myelination to axons to insulate them.

•MYELIN = PHOSPHOLIPID  bilayer derived from cell membranes

• Myelin prevents the action potential to escape out from the neuron.

        EPENDYMAL CELLS:

                                                         

•These are simple cuboidal or columnar   epithelium in the ventricles of the brain.

• They secrete CSF via the anterior choroid plexus.

•They bear cilia to circulate cerebro spinal fluid.

 DISORDERS OF NEUROGLIAL CELLS :

• Neuroglia cells are self replicating cells  located in between the neurons.

•They make more than half of the mass of the brain.

•Therefore, uncontrolled growth causes brain tumour.

•In adults over 45 years of age, 90%  of all brain tumors are called as “GLIOMAS”.

•GLIOMAS = A general category of tumors which includes :

•Oligodendrogliomas

                        

•Astrocytomas

                           

•Ependymomas